PTSD:Treatment
A number of psychotherapy approaches have been developed for the treatment of PTSD Critical Incident Stress Mnagement Early intervention after a traumatic incident, known as Critical Incident Stress Managementritic (CISM) is often used to reduce traumatic effects of an incident, and potentially prevent a full-blown occurrence of PTSD. Considerable research into effective treatments for PTSD has been carried out since its inclusion in DSM-III in 1980. Exposure techniques, which are based on the assumption that individuals habituate to the anxiety provoking memory with a consequent reduction in anxiety, have been frequently used. However some authors have expressed concern about the use of a technique that generates prolonged high levels of anxiety (Fairbank & Brown, 1987) and requires several sessions to achieve a therapeutic effect (Keane, Fairbank & Cadell, 1989). Further, the failure of exposure to have an effect on some patients has been inadequately explained (Wolpe, 1982; Keane et al., 1989). Further, even when exposure techniques seem to have been effective in dealing with some of the symptoms of PTSD, residual difficulties such as nightmares, social isolation and generalised anxiety often remain after treatment (Vaughan & Tarrier, 1992). Eye movement desensitization Relatively recently, a new approach to the treatment of PTSD has emerged for which dramatic claims have been made. The technique, Eye Movement Desensitisation (EMD) alternatively known as Eye Movement Desensitisation and Reprocessing (EMDR) Devilly, G. J., & Spence, S. H. (1999). "The relative efficacy and treatment distress of EMDR and a cognitive behavioral trauma treatment protocol in the amelioration of post traumatic stress disorder". Journal of Anxiety Disorders, 13, 131–157.. Traumatic Incident Reduction is another, more controversial targeted method of treatment. Cognitive precessing therapy Cognitive processing therapy (CPT) is an adaptation of the evidence-based therapy known as cognitive behavioral therapy (CBT) used by clinicians to help consumers explore recovery from posttraumatic stress disorder (PTSD) and related conditions.Resick, P. A., & Schnicke, M. K. (1993). Cognitive processing therapy for rape victims: A treatment manual. Newbury Park, CA: Sage. It is a manualized therapy that includes common elements from general cognitive-behavioral treatments. CPT typically consists of 12 sessions and has been shown to be effective in treating PTSD across a variety of populations, including combat veterans,Monson, C.M. Schnurr, P.P., Resick, P.A., Friedman, M.J., Young-Xu, y., & Stevens, S.P. (2006). Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74, 898-907.Monson, C.M., Price. J.L., Ranslow, E. (2005, October). Treating combat PTSD through cognitive processing therapy. Federal Practitioner, 75-83.Chard, K.M., Schumm, J.A., Owens, G.P., & Cottingham, S.M. (2010). A comparison of OEF and OIF veterans and vietnam veterans receiving cognitive processing therapy. Journal of Traumatic Stress, 23, 25-32. sexual assault victims,Resick, P. A., Galovski, T. E., Uhlmansiek, M. O., Scher, C. D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243–258.Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive processing therapy with prolonged exposure therapy and a waiting list condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867–879.Chard, K.M. (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology, 73, 965–971. and refugees.Schulz, P. M., Resick, P.A., Huber, L.C., Griffin, M.G. (2006). The effectiveness of cognitive processing therapy for PTSD with refugees in a community setting. Cognitive and Behavioral Practice, 13, 322-331. CPT can be provided in individual and group treatment formats. The theory behind CPT conceptualizes PTSD as a disorder of "non-recovery" in which erroneous beliefs about the causes and consequences of traumatic events produce strong negative emotions and prevent accurate processing of the trauma memory and natural emotions emanating from the event. Although PTSD is classified currently as an anxiety disorder, most people with PTSD experience a range of emotions including horror, anger, shame, guilt and sadness as well as fear. A significant contributor to the interruption of natural recovery process is the ongoing use of avoidance as a coping strategy. By avoiding the trauma memory and situations that trigger reactions, people with PTSD limit their opportunities to process the traumatic experience and gain a more adaptive understanding. CPT incorporates trauma-specific cognitive techniques to help individuals with PTSD more accurately appraise these "stuck points" and progress toward recovery. General approach to treatment PTSD is usually treated by a combination of psychotherapy (cognitive-behavioral therapy, group therapy, and exposure therapy are popular) and psychotropic drug therapy (antidepressant or atypical antipsychotics, e.g. brand names such as Prozac (fluoxetine), Effexor (venlafaxin), Zoloft (sertraline), Remeron (mirtazapine), Zyprexa (olanzapine), or Seroquel (quetiapine)). Talk therapy may prove useful, but only insofar as the individual sufferer is enabled to come to terms with the trauma suffered and successfully integrate the experiences in a way that does not further damage the psyche. Forbes, et al, (2001) [http://www.kluweronline.com/article.asp?PIPS=300244&PDF=1 Forbes, D. et al. (2001)] "Brief report: treatment of combat-related nightmares using imagery rehearsal: a pilot study", Journal of Traumatic Stress 14 (2): 433-442 have shown that a technique of "rewriting" the content of nightmares through imagery rehearsal so that they have a resolution can not only reduce the nightmares but also other symptoms. The US Food and Drug Agency (FDA) recently approved a clinical protocol that combines the drug MDMA ("Ecstasy") with talk therapy sessions. Basic counseling for PTSD includes education about the condition and provision of safety and support (Foa 1997). Cognitive therapy shows good results (Resick 2002), and group therapy may be helpful in reducing isolation and Stigma (Foy 2002). Drug treatments Dr. Jan Bastiaans of the Netherlands has developed a form of psychedelic psychotherapy involving LSD, with which he has successfully treated concentration camp survivors who suffer from PTSD.http://www.maps.org/news-letters/v09n2/09203maa.html He also used sodium thiopental See also *Complex Post Traumatic Stress Disorder *Somatic Experiencing References category:Treatment of PTSD